Skip to main content
Top
Published in: Intensive Care Medicine 3/2019

01-03-2019 | Nosocomial Infection | Editorial

Ten tips for the intensive care management of transplanted lung patients

Authors: Tobias Welte, Catherine Ingels, Jordi Rello

Published in: Intensive Care Medicine | Issue 3/2019

Login to get access

Excerpt

Complications following lung transplantation (LTx) are diverse and range from immunologic reactions to cancerous malignancies. The correct identification of the causative pathology requires a purposive diagnostic strategy that considers all these possibilities (Fig. 1). Here, we present ten general tips for the intensive care management of post-LTx patients. However, case-by-case decisions on volume therapy and ventilator strategies should be obtained in a specialized center.
Appendix
Available only for authorised users
Literature
1.
go back to reference Soluri-Marins A, Sutherasan Y, Silva PL, Pelosi P, Rocco PR (2015) How to minimize ventilator-induced lung injury in transplanted lungs. The role of protective ventilation and other strategies. Eur J Anaesthesiol 32:828–836CrossRef Soluri-Marins A, Sutherasan Y, Silva PL, Pelosi P, Rocco PR (2015) How to minimize ventilator-induced lung injury in transplanted lungs. The role of protective ventilation and other strategies. Eur J Anaesthesiol 32:828–836CrossRef
2.
go back to reference European Committee on Organ Transplantation (2018) Guide to the quality and safety of organs for transplantation, 7th edn. EDQM Council of Europe, Strasbourg European Committee on Organ Transplantation (2018) Guide to the quality and safety of organs for transplantation, 7th edn. EDQM Council of Europe, Strasbourg
3.
go back to reference Beer A, Reed RM, Bölükbas S, Budev M, Chaux G, Zamora MR, Snell G, Orens JB, Klesney-Tait JA, Schmidt GA, Brower RG, Eberlein M (2014) Mechanical ventilation after lung transplantation. An international survey of practices and preferences. Ann Am Thorac Soc 11:546–553CrossRef Beer A, Reed RM, Bölükbas S, Budev M, Chaux G, Zamora MR, Snell G, Orens JB, Klesney-Tait JA, Schmidt GA, Brower RG, Eberlein M (2014) Mechanical ventilation after lung transplantation. An international survey of practices and preferences. Ann Am Thorac Soc 11:546–553CrossRef
4.
go back to reference Hansen LN, Ravn JB, Yndgaard S (2003) Early extubation after single-lung transplantation: analysis of the first 106 cases. J Cardiothorac Vasc Anesth 17:36–39CrossRef Hansen LN, Ravn JB, Yndgaard S (2003) Early extubation after single-lung transplantation: analysis of the first 106 cases. J Cardiothorac Vasc Anesth 17:36–39CrossRef
5.
go back to reference Fuehner T, Greer M, Welte T, Gottlieb J (2012) The lung transplant patient in the ICU. Curr Opin Crit Care 18(5):472–478CrossRef Fuehner T, Greer M, Welte T, Gottlieb J (2012) The lung transplant patient in the ICU. Curr Opin Crit Care 18(5):472–478CrossRef
6.
go back to reference Jacques F, El-Hamamsy I, Fortier A, Maltais S, Perrault LP, Liberman M, Noiseux N, Ferraro P (2012) Acute renal failure following lung transplantation: risk factors, mortality, and long-term consequences. Eur J Cardiothorac Surg 41:193–199PubMed Jacques F, El-Hamamsy I, Fortier A, Maltais S, Perrault LP, Liberman M, Noiseux N, Ferraro P (2012) Acute renal failure following lung transplantation: risk factors, mortality, and long-term consequences. Eur J Cardiothorac Surg 41:193–199PubMed
7.
go back to reference Högerle BA, Kohli N, Habibi-Parker K, Lyster H, Reed A, Martin-Carby A, Zeriouh M, Weymann A, Sabashnikov AR, Popov AF, Sores S, Benjamin A (2016) Challenging immunosuppression treatment in lung transplant recipients with kidney failure. Transpl Immunol 35:18–22CrossRef Högerle BA, Kohli N, Habibi-Parker K, Lyster H, Reed A, Martin-Carby A, Zeriouh M, Weymann A, Sabashnikov AR, Popov AF, Sores S, Benjamin A (2016) Challenging immunosuppression treatment in lung transplant recipients with kidney failure. Transpl Immunol 35:18–22CrossRef
8.
go back to reference Palacio F, Reyes LF, Levine DJ, Sanchez JE, Angel LE, Fernandez JF, Levine S, Rello J, Abedi A, Restrepo MI (2015) Understanding the concept of health care-associated pneumonia in lung transplant recipients. Chest 148:516–522CrossRef Palacio F, Reyes LF, Levine DJ, Sanchez JE, Angel LE, Fernandez JF, Levine S, Rello J, Abedi A, Restrepo MI (2015) Understanding the concept of health care-associated pneumonia in lung transplant recipients. Chest 148:516–522CrossRef
9.
go back to reference Manuel O, López-Medrano F, Keiser L, Welte T, Carratalà J, Cordero E, Hirsch HH, ESCMID Study Group of Infection in Compromised Hosts (ESGICH) (2014) Influenza and other respiratory virus infections in solid organ transplant recipients. Clin Microbiol Infect 20(Suppl 7):102–108CrossRef Manuel O, López-Medrano F, Keiser L, Welte T, Carratalà J, Cordero E, Hirsch HH, ESCMID Study Group of Infection in Compromised Hosts (ESGICH) (2014) Influenza and other respiratory virus infections in solid organ transplant recipients. Clin Microbiol Infect 20(Suppl 7):102–108CrossRef
10.
go back to reference Gottlieb J, Schulz TF, Welte T, Fuehner T, Dierich M, Simon AR, Engelmann I (2009) Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation 87:1530–1537CrossRef Gottlieb J, Schulz TF, Welte T, Fuehner T, Dierich M, Simon AR, Engelmann I (2009) Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation 87:1530–1537CrossRef
11.
go back to reference Varela A, Hoyos L, Romero A, Campo-Cañaveral JL, Crowley S (2018) Management of bronchial complications after lung transplantation and sequelae. Thorac Surg Clin 28:365–375CrossRef Varela A, Hoyos L, Romero A, Campo-Cañaveral JL, Crowley S (2018) Management of bronchial complications after lung transplantation and sequelae. Thorac Surg Clin 28:365–375CrossRef
12.
go back to reference Porteous MK, Diamond JM, Christie JD (2015) Primary graft dysfunction: lessons learned about the first 72 h after lung transplantation. Curr Opin Organ Transpl 20:506–514CrossRef Porteous MK, Diamond JM, Christie JD (2015) Primary graft dysfunction: lessons learned about the first 72 h after lung transplantation. Curr Opin Organ Transpl 20:506–514CrossRef
13.
go back to reference Mazo C, Borgatta B, Pont T, Sandiumenge A, Moyano S, Roman A, Rello J (2018) Procalcitonin accurately predicts lung transplant adults with low risk of pulmonary graft dysfunction and intensive care mortality. J Crit Care 44:142–147CrossRef Mazo C, Borgatta B, Pont T, Sandiumenge A, Moyano S, Roman A, Rello J (2018) Procalcitonin accurately predicts lung transplant adults with low risk of pulmonary graft dysfunction and intensive care mortality. J Crit Care 44:142–147CrossRef
Metadata
Title
Ten tips for the intensive care management of transplanted lung patients
Authors
Tobias Welte
Catherine Ingels
Jordi Rello
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 3/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-019-05578-1

Other articles of this Issue 3/2019

Intensive Care Medicine 3/2019 Go to the issue